Statistical and methodological challenges for disaster preparedness and medical needs assessment in Rio Grande Valley of Texas

In recent years, disaster preparedness through assessment of medical and special needs persons (MSNP) has taken a center place in public eye in effect of frequent natural disasters such as hurricanes, storm surge or tsunami due to climate change and increased human activity on our planet. Statistical methods complex survey design and analysis have equally gained significance as a consequence. However, there exist many challenges still, to infer such assessments over the target population for policy level advocacy and implementation. ^ Objective. This study discusses the use of some of the statistical methods for disaster preparedness and medical needs assessment to facilitate local and state governments for its policy level decision making and logistic support to avoid any loss of life and property in future calamities. ^ Methods. In order to obtain precise and unbiased estimates for Medical Special Needs Persons (MSNP) and disaster preparedness for evacuation in Rio Grande Valley (RGV) of Texas, a stratified and cluster-randomized multi-stage sampling design was implemented. US School of Public Health, Brownsville surveyed 3088 households in three counties namely Cameron, Hidalgo, and Willacy. Multiple statistical methods were implemented and estimates were obtained taking into count probability of selection and clustering effects. Statistical methods for data analysis discussed were Multivariate Linear Regression (MLR), Survey Linear Regression (Svy-Reg), Generalized Estimation Equation (GEE) and Multilevel Mixed Models (MLM) all with and without sampling weights. ^ Results. Estimated population for RGV was 1,146,796. There were 51.5% female, 90% Hispanic, 73% married, 56% unemployed and 37% with their personal transport. 40% people attained education up to elementary school, another 42% reaching high school and only 18% went to college. Median household income is less than $15,000/year. MSNP estimated to be 44,196 (3.98%) [95% CI: 39,029; 51,123]. All statistical models are in concordance with MSNP estimates ranging from 44,000 to 48,000. MSNP estimates for statistical methods are: MLR (47,707; 95% CI: 42,462; 52,999), MLR with weights (45,882; 95% CI: 39,792; 51,972), Bootstrap Regression (47,730; 95% CI: 41,629; 53,785), GEE (47,649; 95% CI: 41,629; 53,670), GEE with weights (45,076; 95% CI: 39,029; 51,123), Svy-Reg (44,196; 95% CI: 40,004; 48,390) and MLM (46,513; 95% CI: 39,869; 53,157). ^ Conclusion. RGV is a flood zone, most susceptible to hurricanes and other natural disasters. People in the region are mostly Hispanic, under-educated with least income levels in the U.S. In case of any disaster people in large are incapacitated with only 37% have their personal transport to take care of MSNP. Local and state government’s intervention in terms of planning, preparation and support for evacuation is necessary in any such disaster to avoid loss of precious human life. ^ Key words: Complex Surveys, statistical methods, multilevel models, cluster randomized, sampling weights, raking, survey regression, generalized estimation equations (GEE), random effects, Intracluster correlation coefficient (ICC).^

A methodologic study of pain assessment in Anglo and Hispanic children with cancer

There is growing clinical evidence that even young children experience pain and accompanying anxiety. Few instruments have been validated to assess pain characteristics in children. The study of related demographic, illness, psychologic and parental factors in children has also been limited. This study examines the reliability and validity of pain assessment tools in an outpatient pediatric cancer population. A total of 78 children from three to fifteen years of age were observed and interviewed about the pain of invasive procedures. The effect of cultural factors and the stress of acculturation were examined by comparing data from two cultural groups, Anglo and Hispanic.^ Spielberger State-Trait Anxiety Scales were administered to children and parents prior to an invasive procedure. The Procedure Behavioral Checklist (PBCL) was used for observation of the child's response during the procedure. The Children's Procedural Interview (CPI) which contains items on the PBCL and visual analogues (scales of faces indicating varying degrees of pain and anxiety) was administered following the procedure.^ Reliability coefficients for Anglos were.78 on the PBCL,.79 on the CPI and.85 on the visual analogue scales. For Hispanics, the reliability for the PBCL was.54, while the CPI had a reliability of.72 and the visual analogue scales,.87. Construct validity was demonstrated by high correlations between the PBCL and CPI scores for both ethnic groups (.66 for Anglos and.64 for Hispanics) and by the significant correlation of State anxiety scores with both PBCL and CPI scores. Age was inversely correlated with PBCL and CPI scores for both ethnic groups. Hispanic parents' anxiety scores were higher than Anglo parents, but were not highly correlated with their child's PBCL, CPI or State-Trait anxiety scores. Caregivers' ratings were correlated with the PBCL scores for Anglos but not for Hispanics.^ The findings of this study indicate that pain responses may be reliably assessed using both observational and self-report methods in children, though differences in Anglo and Hispanic cultures exist. Differences in pain symptomatology and assessment in the two cultural groups warrant further study. ^

Quality assessment in radiation oncology

Oncologic specialty societies and multidisciplinary collaborative groups have dedicated considerable effort to developing evidence-based quality indicators (QIs) to facilitate quality improvement, accreditation, benchmarking, reimbursement, maintenance of certification, and regulatory reporting. In particular, radiation oncology as a field has a long history of organized quality assessment efforts, and continues to work toward developing consensus quality standards in the face of continually evolving technologies and standards of care. The present report provides a comprehensive review of the current state of quality assessment in radiation oncology, with an emphasis on recent quality improvement efforts. Specifically, this report aims to highlight implications of the healthcare quality movement for radiation oncology and review existing efforts to define and measure quality in the field, with particular focus on dimensions of quality that are specific to radiation oncology within the "big picture" of oncologic quality improvement efforts.^

Effects of ocean acidification on visual risk assessment in coral reef fishes

1. With the global increase in CO2 emissions, there is a pressing need for studies aimed at understanding the effects of ocean acidification on marine ecosystems. Several studies have reported that exposure to CO2 impairs chemosensory responses of juvenile coral reef fishes to predators. Moreover, one recent study pointed to impaired responses of reef fish to auditory cues that indicate risky locations. These studies suggest that altered behaviour following exposure to elevated CO2 is caused by a systemic effect at the neural level. 2. The goal of our experiment was to test whether juvenile damselfish Pomacentrus amboinensis exposed to different levels of CO2 would respond differently to a potential threat, the sight of a large novel coral reef fish, a spiny chromis, Acanthochromis polyancanthus, placed in a watertight bag. 3. Juvenile damselfish exposed to 440 (current day control), 550 or 700 µatm CO2 did not differ in their response to the chromis. However, fish exposed to 850 µatm showed reduced antipredator responses; they failed to show the same reduction in foraging, activity and area use in response to the chromis. Moreover, they moved closer to the chromis and lacked any bobbing behaviour typically displayed by juvenile damselfishes in threatening situations. 4. Our results are the first to suggest that response to visual cues of risk may be impaired by CO2 and provide strong evidence that the multi-sensory effects of CO2 may stem from systematic effects at the neural level.

Alternative Assessment in Engineering Language Education: The case of the Technical University of Madrid

This article describes a research project involving students from nine different engineering degrees at the Technical university of Madrid. The purpose of the project was to analyze the use of peer and self assessment and the students? attitudes toward alternative assessment procedures.

E-comparisons: A new approach to round robin tests for environmental noise assessment in transport infrastructures

The increasing importance of pollutant noise has led to the creation of many new noise testing laboratories in recent years. For this reason and due to the legal implications that noise reporting may have, it is necessary to create procedures intended to guarantee the quality of the testing and its results. For instance, the ISO/IEC standard 17025:2005 specifies general requirements for the competence of testing laboratories. In this standard, interlaboratory comparisons are one of the main measures that must be applied to guarantee the quality of laboratories when applying specific methodologies for testing. In the specific case of environmental noise, round robin tests are usually difficult to design, as it is difficult to find scenarios that can be available and controlled while the participants carry out the measurements. Monitoring and controlling the factors that can influence the measurements (source emissions, propagation, background noise…) is not usually affordable, so the most extended solution is to create very effortless scenarios, where most of the factors that can have an influence on the results are excluded (sampling, processing of results, background noise, source detection…) The new approach described in this paper only requires the organizer to make actual measurements (or prepare virtual ones). Applying and interpreting a common reference document (standard, regulation…), the participants must analyze these input data independently to provide the results, which will be compared among the participants. The measurement costs are severely reduced for the participants, there is no need to monitor the scenario conditions, and almost any relevant factor can be included in this methodology

Stability and Transient Performance Assessment in a COTS-Module-Based Distributed DC/DC System

This paper introduces a method to analyze and predict stability and transient performance of a distributed system where COTS (Commercial-off-the-shelf) modules share an input filter. The presented procedure is based on the measured data from the input and output terminals of the power modules. The required information for the analysis is obtained by performing frequency response measurements for each converter. This attained data is utilized to compute special transfer functions, which partly determine the source and load interactions within the converters. The system level dynamic description is constructed based on the measured and computed transfer functions introducing cross-coupling mechanisms within the system. System stability can be studied based on the well-known impedance- related minor-loop gain at an arbitrary interface within the system.

Pounding force assessment in performance-based design of bridges

Bridges with deck supported on either sliding or elastomeric bearings are very common in mid-seismicity regions. Their main seismic vulnerabilities are related to the pounding of the deck against abutments or between the different deck elements. A simplified model of the longitudinal behavior of those bridges will allow to characterize the reaction forces developed during pounding using the Pacific Earthquake Engineering Research Center framework formula. In order to ensure the general applicability of the results obtained, a large number of system parameter combinations will be considered. The heart of the formula is the identification of suitable intermediate variables. First, the pseudo acceleration spectral value for the fundamental period of the system (Sa(Ts)) will be used as an intensity measure (IM). This IM will result in a very large non-explained variability of the engineering demand parameter. A portion of this variability will be proved to be related to the relative content of high-frequency energy in the input motion. Two vector-valued IMs including a second parameter taking this energy content into account will then be considered. For both of them, a suitable form for the conditional intensity dependence of the response will be obtained. The question of which one to choose will also be analyzed. Finally, additional issues related to the IM will be studied: its applicability to pulse-type records, the validity of scaling records and the sufficiency of the IM.

Mealiness assessment in apples and peaches using MRI techniques

Mealiness (woolliness in peaches) is a negative attribute of sensory texture that combines the sensation of a desegregated tissue with the sensation of lack of juiciness. In this study, 24 apples cv. Top Red and 8 peaches cv. Maycrest, submitted to 3 and 2 different storage conditions respectively have been tested by mechanical and MRI techniques to assess mealiness. With this study, the results obtained on apples in a previous work have been validated using mathematical features from the histograms of the T2 maps: more skewed and the presence of a tail in mealy apples, similar to internal breakdown. In peaches, MRI techniques can also be used to identify woolly fruits. Not all the changes found in the histograms of woolly peaches are similar from those observed in mealy apples pointing to a different underlying physiological change in both disorders.

Forest Biodiversity Assessment in Peruvian Andean Montane Cloud Forest

Cloud forests are unusual and fragile habitats, being one of the least studied and least understood ecosystems. The tropical Andean dominion is considered one of the most significant places in the world as rega rds biological diversity, with a very high level of endemism. The biodiversity was analysed in an isolated remnant area of a tropical montane cloud forest known as the ?Bosque de Neblina de Cuyas?, in the North of the Peruvian Andean range. Composition, structure and dead wood were measured or estimated. The values obtained were compared with other cloud forests. The study revealed a high level of forest biodiversity, although the level of biodiversity differs from one area to another: in the inner areas, where human pressure is almost inexistent, the biodiversity values increase. The high species richness and the low dominance among species bear testimony to this montane cloud forest as a real enclave of biodiversity.

Woolliness assessment in peaches. Comparison between human and instrumental procedures and results

Woolliness, a negative attribute of sensory texture, is characterised by the lack of juiciness without variation of the tissue water content an incapacity of ripening although there is external ripe appearance. In this study, peaches cv Springcrest (early and soft flesh peaches) and Miraflores (late and hard flesh peaches) corresponding to three different maturity stages at harvest, stored 0, 1, 2, 3 and 4 weeks at 1 and 5°C have been tested by instrumental and sensory means. A Instrumental classification of woolliness has been compared to the sensory assessment. For Springcrest peaches the sensory results match with those found for the instrumental procedure. In this case , Woolliness appears after 2 weeks of storage at 5°C, changing abruptly from crispy to woolly. Miraflores peaches did not develop woolliness during storage. After comparing with sensory results, it is shown that a common instrumental scale may be appropriate to classify for woolliness all peach varieties.

MRI and Bidimensional relaxometry sequences for macro and microstructure assessment in food models.

Physico-chemical and organoleptic characteristics of food depend largely on the microscopic level distribution of gases and water, and connectivity and mobility through the pores. Microstructural characterization of food can be accomplished by Magnetic Resonance Imaging (MRI) and Nuclear Magnetic Spectroscopy (NMR) combined with the application of methods of dissemination and multidimensional relaxometry. In this work, funded by the EC Project InsideFood, several artificial food models, based on foams and gels were studied using MRI and 2D relaxometry. Two different kinds of foams were used: a sugarless and a sugar foam. Then, a half of a syringe was filled with the sugarless foam and the other half with the sugar foam. Then, MRI and NMR experiments were performed and the sample evolution was observed along 3 days in order to quantify macrostructural changes through proton density images and microstructural ones using T1T2 maps, using an inversion CPMG sequence. On the proton density images it may be seen that after 16 hours it was possible to differentiate the macrostructural changes, as the apparition of free water due to a syneresis phenomenon. On the interface it can be seen a brighter area after 16 hours, due to the occurrence of free water. Moreover, thanks to the bidimensional relaxometry (T1-T2) it was possible to differentiate among microscopic changes. Differences between the pores size can be observed as well as the microstructure evolution after 30.5 hours, as a consequence differences are shown on free water redistribution through larger pores and capillarity phenomena between both foams.

Detailed damage mechanisms assessment in composite materials by means of X-ray tomography

This research focused on the evaluation of damage formation on ±45º carbon fiber laminates subjected to tensile tests. The damage was evaluated by means of X-ray tomography. A high density of cracks developed during the plateau of the stress-strain curve and were qualitatively analyzed, showing that the inner plies eventually developed a higher crack concentration than the outer plies. Delamination started to occur in the outermost ply interface when the slope after the plateau of the stress-strain curve began to increase.

Quantity and degree assessment in an RDF.based semantic language

This paper introduces a semantic language developed with the objective to be used in a semantic analyzer based on linguistic and world knowledge. Linguistic knowledge is provided by a Combinatorial Dictionary and several sets of rules. Extra-linguistic information is stored in an Ontology. The meaning of the text is represented by means of a series of RDF-type triples of the form predicate (subject, object). Semantic analyzer is one of the options of the multifunctional ETAP-3 linguistic processor. The analyzer can be used for Information Extraction and Question Answering. We describe semantic representation of expressions that provide an assessment of the number of objects involved and/or give a quantitative evaluation of different types of attributes. We focus on the following aspects: 1) parametric and non-parametric attributes; 2) gradable and non-gradable attributes; 3) ontological representation of different classes of attributes; 4) absolute and relative quantitative assessment; 5) punctual and interval quantitative assessment; 6) intervals with precise and fuzzy boundaries

Environmental risk assessment in open pit blasting operations: compliance with ISO 31010:2010

All activities of an organization involve risks that should be managed. The risk management process aids decision making by taking account of uncertainty and the possibility of future events or circumstances (intended or unintended) and their effects on agreed objectives. With that idea, new ISO Standard has been drawn up. ISO 31010 has been recently issued which provides a structured process that identifies how objectives may be affected, and analyses the risk in term of consequences and their probabilities before deciding on whether further treatment is required. In this lecture, that ISO Standard has been adapted to Open Pit Blasting Operations, focusing in Environmental effects which can be managed properly. Technique used is Fault Tree Analysis (FTA), which is applied in all possible scenarios, providing to Blasting Professionals the tools to identify, analyze and manage environmental effects in blasting operations. Also this lecture can help to minimize each effect, studying each case. This paper also can be useful to Project Managers and Occupational Health and Safety Departments (OH&S) because blasting operations can be evaluated and compared one to each other to determine the risks that should be managed in different case studies. The environmental effects studied are: ground vibrations, flyrock and air overpressure (airblast). Sometimes, blasting operations are carried out near populated areas where environmental effects may impose several limitations on the use of explosives. In those cases, where these factors approach certain limits, National Standards and Regulations have to be applied.